# 一名個案血清K+ 2.8 mEq/L，醫囑KCl 40 mEq IV。哪一種給藥作法最安全？

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391822&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一名個案血清K+ 2.8 mEq/L，醫囑KCl 40 mEq IV。哪一種給藥作法最安全？

## 選項

1. 未稀釋直接靜脈推注
2. 使用輸注幫浦，末梢管路最高10 mEq/hr（中心管路20 mEq/hr），並持續心臟監測 **✔ 正確答案**
3. 混入50 mL袋中快速輸注
4. 皮下注射以便較慢吸收

**正確答案: 2**

## 解析

正確（2）：KCl屬於ISMP高警訊藥品，絕不可IV push。標準最高輸注速率為末梢10 mEq/hr、中心20 mEq/hr（需監測；只有特定急救單位才有更高速率例外）。使用幫浦、持續心電監測並適當稀釋。（1、3、4）可能致命。

## 深入解析

記憶提示 KCl快速推注很危險。高警訊藥品要確認幫浦、管路、稀釋和監測；輸注部位灼痛表示需降速或換較大靜脈。

## 臨床情境

情境 60歲男性低血鉀（K+ 2.8 mEq/L），無心律不整，尿量50 mL/hr。醫囑KCl 40 mEq IV。

## 重要概念

- **靜脈氯化鉀** — 高警訊藥品；快速推注可能造成心搏停止。
- **KCl最高輸注速率** — 標準為末梢10 mEq/hr、中心20 mEq/hr。
- **KCl外滲** — 輸注部位灼痛是警訊；降低速率或換到較大靜脈，絕不可推注。

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